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Selective lymphadenectomy for penile cancer
S Bucher1, M Guerra, D Ribuffo
1Division of Plastic Surgery, Istituto San Gallicano IRCCS, Rome, Italy.
Introduction:
Lymph node treatment in patients with penile cancer has been longly debated in the last 15 years, with surgeons advocating therapeutic lymphadenectomy and others advocating selective lymphadenectomy (SLND).
Materials And Methods:
We evaluated the outcome of clinically node negative penile cancer patients treated with SLND. Since March 2000, 35 node negative penile cancer patients were operated on mainly at the Division of Plastic Surgery, San Gallicano Institute, Rome (Italy), with SLND.
Results:
A sentinel node was detected in 34 out of 35 patients (42 groins). With a minimum of five years follow up, metastases were noted in 5 out of 35 patients. Out of the remaining 30 patients, 2 developed node metastases in the operated inguinal region (6.6%).
Discussion:
SLND for penile cancer compared to surveillance only greatly improves survival rate and disease-free rate (91% vs 79% after 3 years follow-up). Identification of more specific markers for SCC lymph node metastases will make the false negative-rate drop further.